Individual
TINA MARIE VAN WYHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.T.
Contact information
Practice address
27410 S HICKORY ST, BEECHER, IL 60401-3497
(708) 946-6096
(708) 946-2895
Mailing address
27410 S HICKORY ST, BEECHER, IL 60401-3497
(708) 946-6096
(708) 946-2895
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
TP97450200P
IL
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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